Standing Balance Research Articles

Effects of Acute Hypocapnia on Postural Standing Balance Measured by Sharpened Romberg Testing (SRT) in Healthy Subjects.

The sharpened Romberg test (SRT) is a physical maneuver that has been used to identify ataxia in individuals in resource-limited settings. Previous research has suggested that performance on balance testing may be affected by hypocapnia. In this study, we sought to determine whether acute hyperventilation-induced hypocapnia affects performance on the SRT at 501 meters above sea level. We recruited 22 healthy subjects. Each subject performed a baseline SRT. Subjects were then asked to hyperventilate to the point of hypocapnia, confirmed by measurement with a capnometer. Subjects were then asked to re-perform SRT. The primary endpoint was time to loss of balance, measured as time-to-stepout. Time-to-stepout (TTS) on SRT at baseline had a mean ± standard deviation of 101 ± 117 s. In the hypocapnic condition, TTS was reduced to 48 ± 68 s. TTS normalized to 121 ± 132 s after recovery to normal capnic levels. Time-to-stepout was found to be significantly shorter in the hypocapnic measurement compared to the baseline measurement (P = .0128). Statistical analysis was conducted using one-tailed, paired sample T-tests using a P-value of < .05. Our study found a statistically and clinically significant reduction in performance on a balance test (SRT) when exposed to acute hyperventilation-induced hypocapnia compared to a eucapnic control. Our results suggest that acute hypocapnia may contribute to neurological dysfunction independently of hypobaric hypoxia.

Physical test instrument: a development study for junior Karateka in the kata category

Good physical condition is very important for the karate martial arts branch, especially the kata category. Where physical condition is the main supporting factor so that the ability of kihon, kumite and kata karateka can develop properly. Therefore, it is necessary to develop a valid and reliable karate physical condition test and measurement instrument for the kata category so that it can be used in karate development. The purpose of this study was to develop tests and compile a norm instrument for junior category karate physical tests aged 16-17 years that can be used as a measuring tool to test the physical condition of karateka. Research and development (R&amp;D) method. This research was conducted at a karate dojo under the guidance of the Indonesian Karate-Do Sports Federation (FORKI). Small-scale trial subjects included 55 respondents and a large trial group included 114 respondents. The karate trial subjects were 16-17 years old (junior) and determined the trial sample with purposive sampling technique. Data analysis techniques using correlation tests, validity tests and reliability tests. The results of this study showed two series of karate physical test instruments for junior karate athletes (aged 16-17 years) male and female consisting of; V Sit And Reach, Hexagonal Obstacle, Stork Standing balance, Throw Catch Ball tennis, Two Hands Medicine Ball Put, Standing Broad Jump, 2 Minute Sit Ups, Multistage Fitness Test. The validity of the eigenvalue of factor analysis &gt; 1 and can be said to be valid. Reliability is done by re-testing or correlation between the same groups for two treatments. Based on the difference significance test, it shows that t-count = 3.617, df = 59 and P-Value = 0.01 &lt;0.05, which means there is a significant difference in the pre-test and post-test results. Based on this information, it can be said that the physical test instrument model developed is effective, so it can be said that the test used is reliable. In conclusion, 8 items of karate physical test instruments have been produced for junior kata karate category athletes, the preparation of karate physical test norms for junior kata category athletes, and 8 items of physical test instruments have been produced that are effectively used to improve the achievements of junior male and female karate athletes. It is recommended that research be carried out on a larger scope of subjects and a wider research location, so that this measuring instrument product is more tested for feasibility. Keywords: Test Instruments, Condition Physique, Karate juniors, Category Kata

Usefulness of the Kansas University Standing Balance Scale in inpatient rehabilitation: a retrospective validation study.

Adequate balance assessment is essential for designing rehabilitation programs and preventing falls. This study aimed to report the cross-cultural adaptation of the Korean version of the Kansas University Standing Balance Scale (KUSBS), investigate its concurrent and predictive validities, and examine aging-related differences. The adaptation was performed using a standard protocol. In this retrospective study, 1179 patients were included and classified into adult, young-old, old-old, and oldest-old groups. Furthermore, we compared the concurrent, discriminant, and predictive validities of the KUSBS and Berg Balance Scale (BBS). Nonparametric analysis was also conducted. The Spearman rho test revealed strong correlation coefficients between the KUSBS and BBS (r s > 0.7; P < 0.001). At admission, the relationship was strong in the adult, young-old, and old-old groups (r s = 0.931, 0.913, and 0.914, respectively; P < 0.001) but not the oldest-old group (r s = 0.790; P < 0.001). At discharge, the correlation coefficients were above 0.9 in all groups. Additionally, the relationship between the changes in both scales was moderate-to-strong (r s > 0.68; P < 0.001). The predictive validity for independent walking of the KUSBS was strong (r s = 0.791; P < 0.001) and significantly lower than that of the BBS (r s = 0.833; P < 0.001; Z = -3.001; P = 0.003). Furthermore, the cutoff value of the KUSBS at admission to predict independent ambulatory walkers at discharge was 3.5 in ordinal ranking in all age groups. The KUSBS is a reliable and effective tool for measuring balance in patients in inpatient rehabilitation.

The effect of the Pisa syndrome on balance and gait in Parkinson’s disease: a comparative study

INTRODUCTION. Pisa syndrome is a postural deformity that can lead to impaired posture control and balance in patients with Parkinson’s disease (PD), which increases the risk of injury and reduces the quality of life. AIM. To study the effect of the Pisa syndrome on postural control, balance and gait of patients with Parkinson’s disease. HYPOTHESIS. It is assumed that patients with PD with the Pisa syndrome will have specific features of postural control and balance, which must be taken into account when developing rehabilitation technologies for correcting postural disorders. MATERIALS AND METHODS. As part of the comparative study, 30 people of both sexes were examined, all study participants received levodopa drugs in an individual dosage selected by a neurologist-parkinsonologist. The subjects were divided into 2 groups of 15 people each according to the principle of the presence of the Pisa syndrome and its absence. Criteria for inclusion in the groups: voluntary informed consent of persons with PD for the study; age from 45–80 years, stage 2–4 of Hoehn-Yahr Parkinson’s disease, absence of other diseases and gross cognitive impairment. The diagnosis was carried out using the COBS Physiomed stabilometry system and the EQ-5D-3L questionnaire, a diary of falls and a dynamic gait index (DGI). The reliability of the differences was determined by the Mann-Whitney U-test. Data processing was carried out using the Statistica 10 program. RESULTS. Significant differences were revealed in the parameter of the coordination index of the Standing Balance test for the right leg and on the EQ-5D-3L scale at a significance level of p 0.05, in the group of people with PD without the Pisa syndrome, the quality of life was significantly higher, the number of falls was significantly higher in the group of people suffering from PD with the Pisa syndrome towers. DISCUSSION. Walking with a change of direction and multitasking is the most significant problem for people with PD with the Pisa syndrome, the differences between the groups are significant at a significance level of p 0.01. CONCLUSION. Patients with PD and Pisa syndrome have altered gait associated with body tilt forward, instability and decreased balance control.

Clinical Rehabilitation Practice Guidelines on Standing Balance Disorder in Patients with Stroke

Clinical Rehabilitation Practice Guidelines on Standing Balance Disorder in Patients with Stroke

Impaired Standing Balance in Older Adults with Cognitive Impairment after a Severe Fall

Introduction: Fall-related sequelae as well as balance and gait impairments are more pronounced in older adults who are cognitively impaired (OACI) compared to older adults who are cognitively healthy (OACH). Evidence is scarce about differences in standing balance and gait in OACH and OACI after a fall, even though these are major risks for recurrent falls. Thus, the aim of this study was to investigate early impairments in gait and balance, by adding inertial measurement units (IMUs) to a functional performance test in OACH and OACI after a severe fall with a presentation to the emergency department (ED) and immediate discharge. Methods: The study sample was stratified into participants with and without probable cognitive impairment using the result of the Montreal Cognitive Assessment total score (maximum of 30 points). The cutoff for probable cognitive impairment was set at ≤ 24. Standing balance and gait parameters were measured using three IMUs in n = 69 OACH (72.0 ± 8.2 years) and n = 76 OACI (78.7 ± 8.1 years). Data were collected at participants’ homes as part of a comprehensive geriatric assessment in the “SeFallED” study within 4 weeks after presentation to the ED after a severe fall (German Clinical Trials Register ID: 00025949). ANCOVA was used for statistical analysis, adjusted for age. Results: The data indicated significantly more sway for OACI compared to OACH during balance tasks, whereas no differences in gait behavior were found. In detail, differences in standing balance were revealed for mean velocity (m/s) during parallel stance with eyes open (ηp2 = 0.190, p < 0.001) and eyes closed on a balance cushion (ηp2 = 0.059, p = 0.029), as well as during tandem stance (ηp2 = 0.034, p = 0.044) between OACI and OACH. Further differences between the two groups were detected for path length (m/s2) during parallel stance with eyes open (ηp2 = 0.144, p < 0.001) and eyes closed (ηp2 = 0.044, p < 0.027) and for range (m/s2) during tandem (ηp2 = 0.036, p = 0.036) and parallel stance with eyes closed (ηp2 = 0.045, p = 0.032). Conclusion: Even though both groups have experienced a severe fall with presentation to the ED in the preceding 4 weeks, balance control among OACI indicated a higher fall risk than among OACH. Therefore, effective secondary fall prevention efforts have to be established, particularly for OACI.

The Effects of Optical Flow Perturbations on Standing Balance in People With Multiple Sclerosis.

Multiple sclerosis is a neurodegenerative disease that causes balance deficits, even in early stages. Evidence suggests that people with multiple sclerosis (PwMS) rely more on vision to maintain balance, and challenging balance with optical flow perturbations may be a practical screening for balance deficits. Whether these perturbations affect standing balance in PwMS is unknown. Therefore, the purpose of this study was to examine how optical flow perturbations affect standing balance in PwMS. We hypothesized that perturbations would cause higher variability in PwMS compared with matched controls during standing and that standing balance would be more susceptible to anterior-posterior (A-P) perturbations than medial-lateral (M-L) perturbations. Thirteen PwMS and 13 controls stood under 3 conditions: unperturbed, M-L perturbation, and A-P perturbations. A-P perturbations caused significantly higher A-P trunk sway variability in PwMS than controls, although both groups had similar center-of-pressure variability. Both perturbations increased variability in A-P trunk sway and center of pressure. Trunk variability data supported the hypothesis that PwMS were more susceptible to optical flow perturbations than controls. However, the hypothesis that A-P perturbations would affect balance more than M-L perturbations was partially supported. These results suggest potential for optical flow perturbations to identify balance deficits in PwMS.

The Influence of Physical Education Over A Semester on the Psycho-Physical Development in Elementary School Students

Study purpose. The aim of this study was to determine the impact of the physical education program over a semester on physical fitness, sport-specific skills (football and basketball) and the quality of life in elementary school students (7th and 8th grade). Materials and methods. 128 students (64 boys and 64 girls) from three elementary schools, aged 13‒14, participated in the study. A battery of five diagnostic tests was used to assess physical fitness: Modified Agility “T” test, Illinois Agility Run Test, 10x5 Shuttle Run Test, Standing Balance Test and 2-Minute Step in Place Test. Training polygons with elements of sports were used to assess football and basketball skills. Determining the level of quality of life was carried out with a pediatric quality of life questionnaire (Pediatric Quality of Life Inventory TM – PedsQL). Results. The study found statistically significant improvements in the results of most physical fitness tests in all team sports on training polygons, as well as in the level of quality of life for both boys and girls in both grades. Conclusion. It can be concluded that the physical education program was well organized and implemented and thus had a positive effect on improving the psycho-physical status of students.

Discriminant Accuracy of Standing Balance Tests for the Level of Gait Dependency in Hospitalized Patients with Alzheimer's Disease.

When determining the level of gait independence in patients with Alzheimer's disease (AD), detailed functional assessment is difficult in some patients. The previous literature has suggested simple standing balance tests for patients with AD due to their ease of implementation in clinical practice and relevance to gait. However, their usefulness for discriminating the level of gait independence remains unclear. This study aimed to investigate the discrimination accuracy of a simple standing balance test in the level of gait independence among hospitalized patients with AD. This cross-sectional study was a post hoc analysis of a study conducted on 63 inpatients with AD in a single hospital. Participants were divided into three groups according to their level of gait independence: independent, modified independent (independent, walking with walking aids), and dependent groups (supervision). Gait independence was determined using the Functional Independence Measure. Four standing balance tests were used - closed-leg, semi-tandem, tandem, and one-leg standings - and the discrimination accuracy of each test was calculated by receiver operating characteristic analysis. One-leg standing was best at discriminating between the independent and modified independent groups (positive predictive value = 80.0%, negative predictive value = 94.1%). Tandem standing was best at discriminating between the modified independent and dependent groups (positive predictive value = 74.1%, negative predictive value = 93.3%). A simple standing balance test may assist in the determining level of gait independence in patients with AD when it is difficult to perform a mobility assessment.

Differences in the Effectiveness of Pilates Exercises and Bobath Exercises on Sitting and Standing Balance in Children with Cerebral Palsy

This study aimed to analyze the effectiveness of Bobath and Pilates exercises on sitting and standing balance in children with cerebral palsy. It utilized a quasi-experimental study design with a two-group pre-test-post-test design. The study included 66 children with cerebral palsy, aged 1-7 years, who were randomly divided into two groups: 33 children received Pilates exercises, and 33 children received Bobath training. The intervention was conducted once a day, three times a week, for 45 minutes over a 16-week period. The results of the paired t-test statistics indicated that Pilates exercises significantly improved sitting balance (p = 0.002) but had no significant effect on standing balance (p = 0.083). On the other hand, Bobath exercises significantly improved both sitting balance (p = 0.001) and standing balance (p = 0.023). Independent t-test results for sitting balance yielded (p = 0.039), and for standing balance (p = 0.034) In conclusion, there were significant differences in both sitting balance and standing balance between the group that underwent Pilates exercises and the group that received Bobath exercises in children with cerebral palsy

Recovery of Quiet Standing Balance and Lower Limb Motor Impairment Early Poststroke: How Are They Related?

Background Recovery of quiet standing balance early poststroke has been poorly investigated using repeated measurements. Objective To investigate (1) the time course of steady-state balance in terms of postural stability and inter-limb symmetry, and (2) longitudinal associations with lower limb motor recovery in the first 3 months poststroke. Methods Forty-eight hemiparetic subjects (age: 58.9 ± 16.1 years) were evaluated at weeks 3, 5, 8, and 12 poststroke. Motor impairments concerned the Fugl-Meyer assessment (FM-LE) and Motricity Index total score (MI-LE) or ankle item separately (MI-ankle). Postural stability during quiet 2-legged stance was calculated as the net center-of-pressure area (COPArea) and direction-dependent velocities (COPVel-ML and COPVel-AP). Dynamic control asymmetry (DCA) and weight-bearing asymmetry (WBA) estimated inter-limb symmetries in balance control and loading. Linear mixed models determined (1) time-dependent change and (2) the between- and within-subject associations between motor impairments and postural stability or inter-limb symmetry. Results Time-dependent improvements were significant for FM-LE, MI-LE, MI-ankle, COPArea, COPVel-ML, and COPVel-AP, and tended to plateau by week 8. DCA and WBA did not exhibit significant change. Between-subject analyses yielded significant regression coefficients for FM-LE, MI-LE, and MI-ankle scores with COPArea, COPVel-ML, and COPVel-AP up until week 8, and with WBA until week 12. Within-subject regression coefficients of motor recovery with change in COPArea, COPVel-ML, COPVel-AP, DCA, or WBA were generally non-significant. Conclusions Postural stability improved significantly in the first 8 weeks poststroke, independent of lower limb motor recovery at the most affected side within subjects. Our findings suggest that subjects preferred to compensate with their less affected side, making metrics reflecting inter-limb asymmetries in balance invariant for change early poststroke. Clinical Trial Registration: Clinicaltrials.gov. unique identifier NCT03728036.

Effects of Motor-Cognitive Dual-Task Standing Balance Exergaming Training on Healthy Older Adults' Standing Balance and Walking Performance.

Objective: This study examined the effects of motor-cognitive dual-task exergaming standing balance training on healthy older adults' static, dynamic, and walking balance. Methods: Twenty-four adults older than 70 years (control group: n = 9, males = 6, balance training group: n = 15, males = 8) completed the experiment. Dual-tasking standing balance training comprised the accurate control of a ping-pong ball on a tray held with both hands, while standing on one leg (analog training) and three modules of Wii Fit™ exergaming (digital training). The duration of balance training was ∼15 minutes per day, 2 days per week for 8 weeks, in total 16 sessions. We measured one-leg standing time, functional reach distance, walking balance evaluated by the distance walked on a narrow beam (4-cm long, 4-cm wide, and 2-cm high) with single and dual tasking, habitual and maximal walking speed, and muscle strength of the hip extensor, hip abductor, hip adductor, knee extensor, and plantarflexor muscle groups in the right leg at baseline and after 8 weeks. Results: Control group decreased, but balance training group increased one-leg standing time. Only the balance training group improved functional reach distance and hip and knee extensor strength. There was no change in walking speed and walking balance in either group. In the balance training group, changes in maximal speed correlated with changes in dual-tasking walking balance and changes in one-leg standing time correlated with changes in single-tasking walking balance. Conclusion: These results suggest that 16 sessions of motor-cognitive dual-task standing exergaming balance training substantially improved healthy older adults' static and dynamic balance and leg muscle strength but failed to improve walking speed and walking balance. Balance exercises specific to walking balance need to be included in balance training to improve walking balance.

Interventions to Improve Standing Balance in Individuals With Incomplete Spinal Cord Injury: A Systematic Review and Meta-Analysis.

Incomplete spinal cord injury (iSCI) often results in impaired balance leading to functional impairments. Recovery of standing balance ability is an important aim of rehabilitative programs. However, limited information is available on effective balance training protocols for individuals with iSCI. To assess the methodological quality and effectiveness of various rehabilitation interventions for improving standing balance in individuals with iSCI. A systematic search was performed in SCOPUS, PEDro, PubMed, and Web of Science from inception until March 2021. Two independent reviewers screened articles for inclusion, extracted data, and evaluated methodological quality of the trials. PEDro Scale was used to assess the quality of randomized controlled trials (RCT) and crossover studies while pre-post trials were assessed using the modified Downs and Black tool. A meta-analysis was performed to quantitatively describe the results. The random effects model was applied to present the pooled effect. Ten RCTs with a total of 222 participants and 15 pre-post trials with 967 participants were analyzed. The mean PEDro score and modified Downs and Black score was 7/10 and 6/9, respectively. The pooled standardized mean difference (SMD) for controlled and uncontrolled trials of body weight-supported training (BWST) interventions was -0.26 (95% CI, -0.70 to 0.18; p = .25) and 0.46 (95% CI, 0.33 to 0.59; p < .001), respectively. The pooled effect size of -0.98 (95% CI, -1.93 to -0.03; p = .04) indicated significant improvements in balance after a combination of BWST and stimulation. Pre-post studies analyzing the effect of virtual reality (VR) training interventions on Berg Balance Scale (BBS) scores in individuals with iSCI reported a mean difference (MD) of 4.22 (95% CI, 1.78 to 6.66; p = .0007). Small effect sizes were seen in pre-post studies of VR+stimulation and aerobic exercise training interventions indicating no significant improvements after training on standing balance measures. This study demonstrated weak evidence to support the use of BWST interventions for overground training for balance rehabilitation in individuals with iSCI. A combination of BWST with stimulation however showed promising results. There is a need for further RCTs in this field to generalize findings. Virtual reality-based balance training has shown significant improvement in standing balance post iSCI. However, these results are based on single group pre-post trials and lack appropriately powered RCTs involving a larger sample size to support this intervention. Given the importance of balance control underpinning all aspects of daily activities, there is a need for further well-designed and appropriately powered RCTs to evaluate specific features of training interventions to improve standing balance function in iSCI.

The association of moderate-to-vigorous and light-intensity physical activity on static balance in middle-aged and older-aged adults.

Falls are the leading cause of injury among adults ≥ 65years of age. Participation in physical activity (PA) is associated with improved balance, though it is impact in the middle-age population is not well understood. The purpose of the current study was to examine the influence of PA intensity on static balance in middle-aged and older aged individuals. Included were middle-aged adults (40-64years) and older adults (≥ 65years) from the 2003-2004years of the National Health and Nutrition Evaluation Survey. Light physical activity (LPA) and moderate-vigorous physical activity (MVPA) were collected via accelerometer and static balance via the Romberg Test of Standing Balance. No significant odds ratio relationship was found between MVPA or LPA and having good static balance in the middle-aged population; 1.04 (95% CI 0.95, 1.13) p = 0.427 and 1.05 (95% CI 0.97, 1.14) p = 0.182, respectively. Whereas, in older adults, every 60-min increase in LPA was significantly associated with 28% higher odds of good balance (95% CI 1.15, 1.41; p < 0.001), and every 10-min increase in MVPA with 25% higher odds of good balance (95% CI 1.08, 1.45; p = 0.006). LPA and MVPA were not associated with good static balance in middle-aged adults, but in older adults LPA was significantly associated with good static balance. A significant relationship is found between age and fall risk, which is a major concern in the aging population.

Relation Between Physical Abilities and Fundamental Motor Skills in Preschoolers

The aim of this study was to determine the interconnection between physical abilities and fundamental motor skills in preschool children. The aim was also to determine the differences in the observed variables in relation to gender.&#x0D; Materials and methods. The testing successfully included 52 preschool children, 30 boys and 22 girls. Five tests of physical ability (modified agility "T" (MAT) test, broad jump test, standing balance test, squat test and sit up test) were used, and fundamental motor skills were assessed with the Test of Gross Motor Development, 3rd edition (TGMD-3). One-way ANOVA was used to determine the effects of gender on results in physical abilities and fundamental motor skills. The Pearson product-moment correlation coefficient was used to determine the relation between physical abilities and fundamental motor skills.&#x0D; The results of this work indicated, in most cases, a moderate and significant correlation of fundamental motor skills and parameters of physical abilities both in the total sample and also individually in boys and girls (p≤0.05). A significant difference in almost all variables of physical abilities and fundamental motor skills was noted in favor of boys (p≤0.05 and p≤0.01), except for the Standing balance test which indicated that there were not considerable differences between the sexes (p &gt; 0.05).&#x0D; Conclusions. So it can be concluded that the information obtained can lead physical education educators to better understanding of the relations between motor status variables, which further enables them to work effectively with children who will, by virtue of a proper physical development and education, become and remain physically active throughout their life.

Keeping balance during head-free smooth pursuit: The role of aging

Standing balance is often more unstable when visually pursuing a moving target than when fixating on a stationary one. These effects are common in both young and older adults when the head is restrained during visual task performance. The present study focused on the role of head motion on standing balance during smooth pursuit as a function of age. Three predictions were tested: a) standing balance is compromised to a greater extent in older than young adults by gaze target pursuit compared to fixation, b) older adults pursue a moving target with greater and more variable head rotation than young adults, and c) greater and more variable head rotation during the smooth pursuit task is associated with greater Center of Pressure (CoP) sway. Twenty-two (22) older (age: 71.7 ± 8.1, 12 M / 10 F) and twenty-three (23) young adults (age: 23.6 ± 2.5, 12 M / 11 F) stood on a force plate while either fixating a stationary or smoothly pursuing a horizontally moving target (31.9° peak-to-peak visual angle). CoP (Bertec Balance Plate), head kinematics (Vicon Motion Analysis) and head-unconstrained gaze (Pupil Labs Invisible) were synchronously recorded. The root means square (RMS) of CoP velocity increased during smooth pursuit compared to fixation regardless of age (p < .05), while the interquartile CoP range increased only in older and not in young participants (p < .05). We also calculated the head rotation range (peak to peak cycle amplitude) of motion and variability (SD of range of motion) across the cycles of the smooth pursuit task. Older adults pursued the moving target employing more variable (p = .022) head yaw rotation than young participants although the mean range of head rotation was similar between groups (p =. 077). The amplitude and variability of head yaw rotation did not correlate with CoP sway measures. Results suggest that head-free pursuing of a moving target decreased balance to a greater extent in old than young individuals when compared to fixation. Nevertheless, postural sway during head-free smooth pursuit was not associated with the extent or variability of head rotation.

The Effect of Prosthetic Ankle Dorsiflexion Stiffness on Standing Balance and Gait Biomechanics in Individuals with Unilateral Transtibial Amputation.

ABSTRACT Introduction Modular prosthetic ankle components have been shown to improve walking in transtibial prosthesis users, but they may reduce stability during standing. Therefore, the stiffness of the prosthetic foot-ankle components may need to be appropriately tuned to provide a balance between walking mobility and standing balance. The present research investigates both concepts to improve our knowledge about how prosthetic ankle stiffness influences standing and walking performance. Methods Ten individuals with unilateral transtibial amputation and categorized as minimum K3-level ambulators participated. Standing balance and gait analyses at three self-selected speeds were performed at three different levels of ankle dorsiflexion stiffness (Soft, Medium, and Firm) using the College Park Venture foot (College Park Industries, Warren, MI, USA). Repeated-measures analyses of variance (ANOVAs) were performed on relevant standing balance, gait spatiotemporal, and roll-over shape (ROS) outcomes. Gait kinetic and kinematic data were analyzed using a one-dimension statistical parametric analysis. Results Ankle dorsiflexion stiffness influenced balance and gait. Overall, the Firm dorsiflexion stiffness provided a smaller body sway on standing balance, a ROS radius close to the one of able-bodied individuals, and reduced step length asymmetry while walking. Furthermore, walking speed had an influence on ROS radii, resulting in a larger radius for slow walking speeds and a smaller one for fast walking speeds. Discussion The Firm stiffness appeared to offer the most advantages for balance and gait. The radius of ROS under the Firm condition, close to the radius of able-bodied individuals, could have caused the improvement in step length symmetry by a greater progression of the center of pressure, resulting in further progression of the prosthetic side. This information, in addition to the observed walking speed effect on ROS radii, encourages us to develop studies to examine the effect of walking speed on foot performance and improve prosthetic foot design to maintain the same gait characteristics under different walking speeds. Clinical Relevance These results improve our understanding of how a specific prosthetic ankle dorsiflexion stiffness affects standing balance and gait, which supports the prosthetist's evaluation process to determine specific individual stiffness for each prosthesis user.

Effect of Pre-Fabricated Toe Separator in Standing and Walking Balance in Individuals with Bilateral Hallux Valgus

Hallux valgus is deviation of forefoot’s first ray toward midline of the body. Hallux valgus identified with proximal phalanx deviating laterally, first metatarsal head deviating medially with angle greater than 15°.The deformity is complex and affect standing balance and walking balance, causing disturbation to daily activities. Pre-fabricated toe separator is widey used in individuals with hallux valgus in order to prevent progression of deformity. It is cheap, easy to find in market, and simply fit inside shoes.

Effect of Pre-Fabricated Toe Separator in Standing and Walking Balance in Individuals with Bilateral Hallux Valgus

Effect of Pre-Fabricated Toe Separator in Standing and Walking Balance in Individuals with Bilateral Hallux Valgus

Differences in the manifestation of balance according to BMI levels for women students of the Faculty of Physical Education and Sports

Abstract Background: Static and dynamic balance are factors of major importance in the manifestation of human motor skills at a higher level. Purpose: The determination of vari-ations in the performance of balance tests for young women students at the Faculty of Physical Education and Sports (48 cases in the 1st year of bachelor's degree), divided and analyzed 3 BMI levels (underweight / 7 cases, normal weight / 34 cases and overweight / 7 cases) and comparing these results with other similar research. Material and method: The testing of the group was scheduled at the Research Center for Human Performance, be-longing to the Faculty of Physical Education and Sports in Galați, in the month of April of the 2018-2019 academic year. For the assessment of balance, 7 tests were used, of which 4 associated with dynamic postural stability (Walk and turn field sobriety test/errors, Func-tional reach test/cm, Fukuda test/degrees of rotation, Bass test/ points) and 3 measuring static stability (Flamingo test/falls, One leg standing with eyes closed/sec, Stork test/sec). Nonparametric tests (Mann-Whitney U) were applied to compare differences between batches. Results: The average values of underweight and normal-weight women are better than those of overweight women for the entire set of assessment tests. The underweight group has the best results for the Standing balance test, Functional reach test, Flamingo test, Walk and turn field sobriety test, Fukuda test, and the normal weight women for Stork test, respectively Bass test. We found a lack of significant thresholds when comparing the results between the 3 groups (P&gt; 0.05) for Stork test, Standing balance test and Functional reach test, so the working hypothesis formulated is only partially confirmed. The only significant difference between underweight and normal weight (P &lt;0.05) is found in the Flamingo test, with better values for underweight. Significant difference thresholds for Flamingo test and Fukuda test are recorded between the underweight and overweight groups (Z values have associated thresholds P&lt;0.05). The most significant differences are found between the normal weight and overweight groups (P &lt;0.05), respectively for the Bass test, Fukuda test and Walk and turn field sobriety test. Conclusion: Constant physical activity (as a feature of the analyzed group) reduces the chances of significant differences in all balance tests between BMI levels. Keywords: female students; university specialization; static and dynamic postural control; physical activity